The Accuracy of Clinical Risk Index for Babies (CRIB-II) for Predicting Mortality of Severely-ill Preterm Neonates

Naveed Akbar; Sana Sarwar; Muhammad Sajid; Munazza Hayat; Amjad Hassan; Areeba Wasim

doi:10.29054/apmc/2020.833

Naveed Akbar Associate Professor of Pediatrics, Fatima Jinnah Medical University, Lahore Pakistan.
Sana Sarwar Assistant Professor of Pediatrics Fatima Jinnah Medical University, Lahore Pakistan
Muhammad Sajid Assistant Professor of Pediatrics Sheikh Zayed Medical College, Rahim Yar Khan Pakistan
Munazza Hayat Registrar, Department of Pediatrics Sir Ganga Ram Hospital, Lahore Pakistan
Amjad Hassan Associate Professor of Pediatrics King Edward Medical University, Lahore Pakistan
Areeba Wasim Post Graduate Resident, Department of Pediatrics Mayo Hospital, Lahore Pakistan

DOI: https://doi.org/10.29054/apmc/2020.833

Keywords: CRIB II score, Neonatal mortality, Prematurity

Abstract

Background: In Pakistan neonatal mortality rate is 47.3 among 1000 live births. Predictors of neonatal mortality risk can be used to prioritize the care for neonates and to improve the outcome. Objective: To determine the accuracy of clinical risk index for babies (CRIB-II) for predicting mortality of severely ill preterm neonates. Study Design: A Cross Sectional Study. Settings: NICU, Department of Pediatrics Unit I and Unit II, Mayo Hospital, Lahore Pakistan. Duration: From January 22, 2016 to July 30, 2016. Methodology: 200 cases fulfilling the selection criteria (Gestational age 2634 weeks, Preterm admitted in NICU within 12 hours of birth), were included in the study by nonprobability, Consecutive Sampling. Babies with lethal malformations were excluded. Data required for CRIB II score was collected and analyzed by SPSS. Results: Out of the 200 cases, 102 patients were male (51 %). Age varies from 1 hour to 9 hours of life with mean of 5.8. Gestational age ranges from 28 weeks to 33 weeks with mean age is 30 weeks. Patients had following diagnosis with number of cases: Respiratory distress syndrome 54; Early onset sepsis 30; PT, JNN, EOS 22; Mild Asphyxia 18; Prematurity 14; RDS, EOS 14; Moderate Asphyxia 10; prematurity, Jaundice neonatorum 8; IUGR 8; Early onset sepsis, DIC 4; PT, NEC, EOS 4. CRIB score has sensitivity of 77.7 %, specificity of 65.4 %. It has positive predictive value of 64.8 %, negative predictive value of 78.2 % & clinical accuracy of 71%. Conclusion: CRIB II score has clinical accuracy of 71 % determining prognosis of severely ill preterm neonates in term of mortality.